Step 1 of 5 20% Are you a current House Call Vet RVA patient?*YesNoAre you requesting euthanasia services?*YesNo Please note: With the ongoing COVID-19 pandemic, we are not currently scheduling appointments for new patients. Please contact us if you have a special need and we will try to assist you. What is your zip code?* Requested Day & Day PartSelect day and day partThursday May 28, 2020 - MorningThursday May 28, 2020 - AfternoonThursday May 28, 2020 - EveningThursday June 04, 2020 - MorningThursday June 04, 2020 - AfternoonThursday June 04, 2020 - EveningThursday June 11, 2020 - MorningThursday June 11, 2020 - AfternoonThursday June 11, 2020 - EveningThursday June 18, 2020 - MorningThursday June 18, 2020 - AfternoonThursday June 18, 2020 - EveningSecondary Choice for Day & Day PartSelect day and day partThursday May 28, 2020 - MorningThursday May 28, 2020 - AfternoonThursday May 28, 2020 - EveningThursday June 04, 2020 - MorningThursday June 04, 2020 - AfternoonThursday June 04, 2020 - EveningThursday June 11, 2020 - MorningThursday June 11, 2020 - AfternoonThursday June 11, 2020 - EveningThursday June 18, 2020 - MorningThursday June 18, 2020 - AfternoonThursday June 18, 2020 - EveningI'm sorry, we don't have your zip code on our normal scheduled routes. Please contact us for pricing for your appointment. Your InformationName* First Last Home PhoneMobile Phone*Email Address* Preferred Contact Method*PhoneEmailTextAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your PetHow many pets are you requesting an appointment for?*Type of pet*DogCatBothName of your pet*Who is your pet’s current veterinarian?Does your pet have any fears, behavioral issues or food allergies?Describe reason for requesting appointment*Please describe reason for euthanasia* Appointment Deposit Price: $150.00 Euthanasia Deposit Price: $275.00 Total $0.00 Our online deposit fee will be credited towards your pet(s) scheduled appointment and recommended treatment plan. Please visit our FAQ sections for more information about our fees, policies and more! We understand that unforeseen situations can come up and you may need to cancel your appointment. Please contact us as soon as possible so we can continue to offer our services to pets in need in a timely manner. Deposit fees are non-refundable if cancellations are made with less than 24 hours notice. Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name Press the submit button below to submit your appointment request. Once we receive your request, we'll be in touch to set the exact time for your appointment.Payment is due in full at the time service is rendered. Estimates are provided upon request. Accepted payment methods include cash, Care Credit or credit card (VISA, Mastercard & American Express).